• 1 Orthopaedic Trauma Institute (OTI), San Francisco General Hospital, University of California San Francisco (UCSF), 2550 23rd Street, Building 9, 2nd Floor, San Francisco, CA 94110 USA
  • 2 Human Motion, Orthopaedics, Sports Medicine and Digital Methods Group, Luxembourg Institute of Health, Transversal Activities, Luxembourg, Luxembourg
  • 3 Southern California Permanente Medical Group, Downey Medical Center, Department of Orthopaedic Surgery, Kaiser Permanente Downey, Downey, CA USA
  • 4 Department of Orthopaedic Surgery, University of Ulm, Ulm, Germany
  • 5 ALTY Orthopaedic Hospital, Kuala Lumpur, Malaysia
  • 6 University of Virginia, Charlottesville, VA USA
  • 7 Department of Trauma and Reconstructive Surgery, University Hospital Tuebingen, Tuebingen, Germany
Indian J Orthop, 2022 Jul;56(7):1112-1122.
PMID: 35813536 DOI: 10.1007/s43465-022-00629-0


BACKGROUND: Patient-Reported Outcome Measures (PROMs) are widely used for measurement of functional outcomes after orthopaedic trauma. However, PROMs rely on patient collaboration and suffer from various types of bias. Wearable Activity Monitors (WAMs) are increasingly used to objectify functional assessment. The objectives of this systematic review were to identify and characterise the WAMs technology and metrics currently used for orthopaedic trauma research.

METHODS: PubMed and Embase biomedical literature search engines were queried. Eligibility criteria included: Human clinical studies published in the English language between 2010 and 2019 involving fracture management and WAMs. Variables collected from each article included: Technology used, vendor/product, WAM body location, metrics measured, measurement time period, year of publication, study geographic location, phase of treatment studied, fractures studied, number of patients studied, sex and age of the study subjects, and study level of evidence. Six investigators reviewed the resulting papers. Descriptive statistics of variables of interest were used to analyse the data.

RESULTS: One hundred and thirty-six papers were available for analysis, showing an increasing trend of publications per year. Accelerometry followed by plantar pressure insoles were the most commonly employed technologies. The most common location for WAM placement was insoles, followed by the waist. The most commonly studied fracture type was hip fractures followed by fragility fractures in general, ankle, "lower extremity", and tibial fractures. The rehabilitation phase following surgery was the most commonly studied period. Sleep duration, activity time or step counts were the most commonly reported WAM metrics. A preferred, clinically validated WAM metric was not identified.

CONCLUSIONS: WAMs have an increasing presence in the orthopaedic trauma literature. The optimal implementation of this technology and its use to understand patients' pre-injury and post-injury functions is currently insufficiently explored and represents an area that will benefit from future study.


SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43465-022-00629-0.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.